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Posting Date: 07/29/2025
Collaborative Wheelchair Options and Accessories Webinar Coming September 30, 2025
Collaborative Wheelchair Options and Accessories Webinar Coming September 30, 2025 This is your opportunity to hear directly from the Medicare contractors regarding Medicare’s criteria necessary for the coverage of wheelchair options and [...]
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Posting Date: 07/29/2025
Learning Medicare Secondary Payer Interactively
Join us for an interactive learning webinar where you can engage and have fun at the same time! It’s all about learning the Part B Medicare Secondary Payer (MSP) provisions with live case scenarios. Providers will understand their [...]
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Posting Date: 02/26/2024
Ambulance Duplicate Claim Denials
Ambulance Duplicate Claim Denials Duplicate trips may be reported on the same claim if the ZIP code for the point of pick-up for both trips is the same. If separate claims are submitted for the same beneficiary on the same day with the same [...]
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Posting Date: 03/27/2025
Ambulance Services and the Advance Beneficiary Notice of Noncoverage
Ambulance Services and the Advance Beneficiary Notice of Noncoverage To follow are Medicare’s guidelines regarding the use of an ABN for ambulance services. Per the Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) [...]
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Posting Date: 01/31/2015
Ambulance Transports Included in SNF Consolidated Billing
Ambulance Transports Included in SNF Consolidated Billing Transport Description Medical Necessity Met Ambulance Billing Modifiers and Other Considerations Who is Responsible for Payment? Reference(s) SNF to [...]
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Posting Date: 04/15/2022
Ambulance Physician Certification Statement Guidelines
Ambulance Physician Certification Statement Guidelines Certification Type Certification Required? Yes/No Who May Sign the Certification Timeframe Other Information /Resources Nonemergency, scheduled, [...]
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Posting Date: 10/27/2022
Coverage of Rural Air Ambulance Services
Coverage of Rural Air Ambulance Services Section 415 of the Medicare Modernization Act of 2003 provides coverage for rural air ambulance services that are reasonable and necessary and ordered by qualified personnel. Medicare considers the [...]
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Posting Date: 04/15/2022
Ambulance Transports Excluded from SNF Consolidated Billing
Ambulance Transports Excluded from SNF Consolidated Billing When a Medicare beneficiary is a resident in a SNF under a Part A stay, not all ambulance transports are included in the PPS (prospective payment system) payment for a SNF. SNF [...]
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Posting Date: 07/29/2025
National Government Services Contractor Advisory Committee Meeting
National Government Services Contractor Advisory Committee Meeting There will be a multi-jurisdictional CAC meeting held on Wednesday 8/20/2025 at 3:30-5:30 p.m. ET, 2:30-4:30 p.m. CT. Meeting details can be found on the National Government [...]
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Posting Date: 12/31/2018
Ambulance Medical Necessity Reminder for ESRD Patients
Ambulance Medical Necessity Reminder for ESRD Patients National Government Services receives a significant amount of dialysis facility ambulance transports that do not meet medical necessity criteria. Documentation must explicitly describe the [...]
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Posting Date: 04/22/2020
Related Content
Related Content Ambulance Services Center MLN® Booklet: Medicare Ambulance Transports Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) Publication 100-02, Medicare Benefit Policy Manual, Chapter 10, [...]
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Posting Date: 06/27/2017
Ambulance Medical Necessity
Ambulance Medical Necessity According to the Centers for Medicare & Medicaid Services’ (CMS) Internet Only Manual (IOM) 100-02, Medicare Benefit Policy Manual, Chapter 10, Ambulance Services; (400 KB) 10.2 - Necessity and Reasonableness [...]
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Posting Date: 06/27/2022
Billing for A0426 or A0428
Billing for A0426 or A0428 National Government Services has been receiving electronic claims with the 2300 REF segment (G1 qualifier) for prior authorization, however, the value entered in REF02 is a ZIP code. This segment is intended for the [...]
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Posting Date: 08/06/2015
Medical Necessity of Ambulance Services
Medical Necessity of Ambulance Services Table of Contents Medical Necessity of Ambulance Services What You Can Do Nearest Appropriate Facility: GY Modifier What You Can Do Related Content [Return to Top] Medical [...]
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Posting Date: 04/29/2022
Proper Claim Submission for Repetitive, Scheduled, Non-Emergent Ambulance Transports
Proper Claim Submission for Repetitive, Scheduled, Non-Emergent Ambulance Transports The CMS implemented the prior authorization of RSNAT. NGS J6 states Illinois, Minnesota, and Wisconsin were added to the RSNAT Model effective with dates [...]
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Posting Date: 11/12/2020
Responsibility of Providing a Properly Executed Physician Certification Statement/Certificate of Medically Necessity
Responsibility of Providing a Properly Executed Physician Certification Statement/Certificate of Medically Necessity Recent National Government Services educational efforts have highlighted an issue between facilities and the ambulance [...]
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